Nipple Discharge

Nipple discharge has many possible causes, from a widened milk duct to a hormone imbalance, and an exam is the only way to know which one applies to you. Sarah Waterman, MD, at Green Mountain Breast Care Center in Stowe, Vermont, evaluates nipple discharge to determine what is behind it and whether treatment is necessary. She examines you, orders imaging when appropriate, and explains what she finds. Call the office or request an appointment online if you experience unexplained nipple discharge.

What is nipple discharge?

Nipple discharge is any fluid that comes from the nipple outside of pregnancy and breastfeeding. It can be clear, milky, yellow, green, brown, or bloody. Some women notice it only when they squeeze the nipple, while others see it staining a bra or shirt on its own.

Dr. Waterman pays attention to whether the fluid comes from one breast or both, what color it is, and whether it appears on its own. Those details shape how she evaluates you, though only an exam and imaging can identify the cause.

What causes nipple discharge?

Dr. Waterman evaluates nipple discharge for a range of causes, including:

• Duct ectasia, where a milk duct widens, and its walls thicken
• Intraductal papilloma, a noncancerous growth that forms within the duct lining
• Fibrocystic breast changes
• Infection, including mastitis and breast abscess
• Elevated prolactin from a pituitary issue
• Prescription drugs such as certain antidepressants and antihypertensives
• Thyroid dysfunction
• Breast cancer

The color and pattern of your discharge give Dr. Waterman useful clues, while further testing confirms the cause.

When should I have nipple discharge evaluated?

Schedule an appointment if you notice any of the following:

• Bloody or clear discharge
• Discharge from only one breast
• Fluid that appears without you squeezing the nipple
• Discharge along with a lump, skin change, or nipple retraction
• Persistent discharge after menopause
• Any discharge that concerns you

Bring notes on when the discharge started, what it looks like, how often it happens, and whether it comes on its own. Avoid squeezing your nipple to check for fluid in the days before your visit, since repeated squeezing keeps the discharge going and can irritate your skin.

How does my doctor evaluate nipple discharge?

Your appointment starts with a clinical breast exam and a discussion of your medical history, medications, and menstrual cycle. Depending on what she finds, Dr. Waterman may order a mammogram, an ultrasound, or both. Bloodwork checks your prolactin and thyroid levels when a hormonal cause seems like a possibility.

If imaging shows something inside a duct, she may recommend a biopsy or surgical duct excision to remove the tissue and examine it under a microscope. Treatment depends entirely on the diagnosis, and many women need nothing beyond reassurance and a follow-up visit.

Call Green Mountain Breast Care Center today or request an appointment online to learn more.